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Maine rates for HCPCS G0247

Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) to include the local care of superficial wounds (i.e., superficial to muscle and fascia) and at least the following, if present: (1) local care of superficial wounds, (2) debridement of corns and calluses, and (3) trimming and debridement of nails

Facilitymedian $72 · 10th–90th $20–$6920%20%10th90th$72Professionalmedian $59 · 10th–90th $18–$1380%5%10th90th$59$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $56.23 / $87.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $63.10 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $75.86 / $204.17
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $56.23 / $95.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $64.57 / $165.96